By Jack Hart
This is one of the central allegations about the Coalition Government’s plans to “privatise the NHS” and this central allegation is much repeated both by left-wing activists and the media. In reality, the NHS is under no threat of privatisation – there has merely been a wilful misunderstanding of what that 49% relates to in order to encourage as much prejudice as possible against this reforming Bill.
The 49% refers to something known as the private patient cap; however the term is a misnomer. The private patient cap doesn’t merely refer to the number of private patients in NHS beds, nor the amount of theatre time private patients use – it refers to privately generated income.
A host of activities are caught with its scope, including joint ventures to develop medical technologies, couples paying for fertility treatments after they have exhausted their NHS entitlement, or even income from treating UK military personnel overseas.
Currently NHS Foundation Trusts have a 2% cap on the proportion of their income that can be generated from non-NHS sources. While the Health and Social Care Bill does, quite rightly, propose to increase this cap to 49%, there would be significant hurdles for any NHS Foundation Trust Board attempting to do this. It should also be remembered that any extra income generated in this manner will all be driven back into the NHS Foundation Trust and used to provide NHS services.While the previous Labour Government, who as we’re all aware welcomed the private sector into the NHS – paying them millions for treatments which were never carried out and guaranteeing them higher tariffs than NHS providers, did introduce a private patient cap of 2% for NHS Foundation Trusts, they never introduced such a cap for NHS Trusts.
While the Health and Social Care Bill plans to change this, there are currently only 141 NHS Foundation Trusts in operation, which means a significant number of NHS Trusts are not covered by that 2% cap – including world respected and renowned hospitals such as Great Ormond Street.
Great Ormond Street Hospital earned over £23 million in 2010 from private patient income, mainly through providing treatment to international patients who would have been unable to access the necessary treatments in their own country. These treatments would have been paid for by foreign governments and healthcare systems. The income generated from this “private” work was then used by Great Ormond Street to invest in NHS services, allowing them to treat even more NHS patients.
How could anyone claim that Great Ormond Street has been privatised or be critical of their care for NHS patients? The point is they can’t.
There is neither political will nor intention to privatise the NHS. Nor is there, as some may claim, an intention to change the core legal purposes of NHS Foundation Trusts: to provide services to NHS patients, free at the point of use, funded from general taxation.
The “private” income raised is used to support NHS activities and the clear examples of NHS Foundation Trusts unburdened by the previous Labour Government’s arbitrary private income ‘cap‘, such as the Royal Marsden Hospital which treats cancer patients at world class standards, demonstrates the benefits such changes will bring for patients.
We should all be proud of the Health and Social Care Bill and not be afraid to stand up to those left-wing activists who have willfully and intentionally misunderstood what the Bill aims to do. The more we expose these blatant attempts to stifle reform of the NHS, the further these reforms can go to ensure that we truly have a world class healthcare system.
Guest blog by Jack Hart. Jack is a parliamentary researcher and he tweets at @MRJacHart